What To Do with Your Practice If You Are Sick Or Dying?
Most of us have a vague notion of what retirement might look like but that’s where our planning usually stops. Getting sick or receiving a terminal diagnosis isn’t something that is easy to think about and is even more difficult to talk about. Nobody wants to contemplate their last moments in this world.
Sadly, we have all witnessed peers who have been thrown a curve ball and had an illness or untimely death. The aftermath of these events places a huge strain on our families. However, these stresses can be lessened with some discussion and at the very least, taking the steps now to get the right people in place when you need them.
An unexpected sickness can occur at the height of our professional careers. Depending on the prognosis, it’s critical to get our affairs in order as quickly as possible. Staff might suspect that something is amiss, and you can ask them to keep health issues confidential.
If you haven’t assembled a team already, start searching for a reputable estate-planning attorney and CPA. Also include the often-overlooked professional; a practice transition broker who can assist with the transition of your practice and can begin the process with you as soon as possible. Most widows/widowers are not thinking that the responsibility of selling the practice will fall on their shoulders. We recommend starting these delicate conversations with your spouse now, so they are not left to deal with this in addition to emotional stress.
If you are still able to work at your practice, we can begin to market the practice heavily but discretely so we can find a buyer as quickly as possible. The best medicine for you is to heal and take care of your family. Selling might seem short-sighted if you expect to make a full recovery, but there are many other options available if you still want to continue to work after you heal.
However, for those doctors who pass unexpectantly, word of mouth tends to get ahead of any marketing and the reality is that your practice will be marketed without a doctor and thus the practice value can decrease substantially. Some of the most difficult challenges that we have encountered are in serving spouses who are left to deal with quickly selling a practice when the doctor is sick or has passed away. The value of the practice drops sharply and is often valued at 30-40% less even after just one month without a doctor.
Prepare for the unexpected. Assemble your professional team and get your estate planning documents in order. Most importantly, make this information accessible and communicate your wishes with your spouse.
Life is short, spend your days doing what you enjoy and take care of your health.
Read MoreInterview Questions for Every Dental Practice Role
By Megan Urban, Practice Transition Advisor
Businesses across the country are struggling with staffing issues and the dental world is NO exception. During the pre-pandemic years finding great staff was a challenge, but since the pandemic began finding and retaining great staff has become a tumultuous experience. What follows are some interview questions that have helped dentists and their practice managers sift through their potential candidates – when you can get candidates. And the increased competition for workers has made this an employee-driven vs. employer-driven market. You’ve got to know your budget and get clear on what additional perks or benefits you may be able to offer in this now highly-competitive hiring process.
General Questions for Every Role – Dentists, Hygienists, Office Managers, Dental Assistants, Front Office, and Sterile Techs
1. What are you looking for in a team and an office?
2. What does self-motivation mean to you?
3. What in particular motivates you?
4. How do you organize your day?
5. In a perfect world, how many hours per day and per week would you like to work?
6. How do you deal with conflict in the workplace? Describe a specific situation and how you dealt with it. Would you do anything differently now that you have had time to reflect?
7. How would the previous dentist who employed you describe you if I were to call him/her? What about the other team members, what would they say? Would they say you were on time every day? Easy to get along with? Fun? Great with the patients?
8. What do you think are your greatest strengths? And what are your greatest challenges?
9. Describe a situation when a patient was upset and describe what you did to rectify the situation or help.
10. What are three things you liked most about your last two positions/offices? What are three things you would have changed and why?
11. Describe a great day at the office.
12. What work situations, tasks, or duties cause you stress?
13. Where would you like to see yourself in two years. Where would you like to see yourself in five years?
14. If you weren’t in the dentistry field, what would you be doing? What are you most passionate about?
15. What qualities in a person do you think are important for this position?
16. How would you set the pay scale for this position? What qualifying events or skills would warrant a different pay scale or increase in compensation?
17. What do you think a bonus should be based on?
18. What benefits are most meaningful to you?
19. What have you learned during the pandemic? How did it affect your short and long-term goals?
20. Did you work remotely? Was that easy or difficult for you? How do you feel about being back in an office, working with a team, and having interaction with patients all day?
Additional Questions for Specific Roles:
Hygiene
1. Describe your normal routine with new patients.
2. What protocol do you follow with perio?
3. What are your thoughts about Arestin, rinses, etcetera.?
4. How do you talk with patients about perio disease? What if they have been undertreated and you are now proposing perio treatment?
5. What is your favorite part of being a hygienist?
6. What have you done in the past to build and grow the hygiene department in an office?
7. How do you discuss unfinished treatment and recall? Provide an example.
8. What do you do if you have a broken appointment? In other offices have you been expected to work your own recall and try to fill your schedule?
9. Are you comfortable working when the dentist is out of the office? (If it’s legal in your area?).
Dental Assistant
1. Have you been involved with placing dental supply orders? Explain your process.
2. What have you normally done during downtime?
3. How do you talk with patients about unfinished treatment and recall? Provide an example.
4. What are your most/least favorite procedures?
5. Describe the perfect dentist to assist and why?
Office/Practice Manager
1. How would you describe your management style?
2. What are your thoughts about micro-managing?
3. What steps do you take when you realize that you have made a hiring mistake?
4. Do you enjoy being at the front desk or in an office behind the scenes?
5. What do you bring to a team to keep them motivated and smiling?
6. In your previous office did you have full responsibility for the accounts receivable? What was your average production to collection ratio?
7. In your previous offices, how would staff describe you?
Front Office
1. How do you welcome new patients to the practice?
2. What have your past responsibilities been? Which did you enjoy most?
3. How do you talk with patients about treatment costs? Provide an exact example of presenting treatment and negotiating a financial arrangement.
4. How do you discuss unfinished treatment and recall?
5. How do you describe a perfect schedule and how do you create it?
6. How do you fill any last-minute appointments?
7. Do you enjoy recall and scheduling?
8. How much experience have you had setting up insurance, submitting claims, and following up with insurance companies for payment?
Dentist
1. What does a perfect schedule look like to you?
2. What is your perio protocol?
3. How do you encourage patients to finish incomplete treatment?
4. How do you ask for referrals from existing patients?
5. What do you do at a new patient appointment?
6. What types of procedures do you most enjoy?
7. Are you comfortable being the only dentist working in the office?
8. What is your typical production per day?
9. How would your current/past dental assistant describe you? How would an owner doctor or office manager describe you?
10. What are your goals for each patient and each day?
11. Is this office located outside any current non-compete you may have?
12. Will you be able to legally bring any patients with you?
Buying Another Location
By Megan Urban, Omni Practice Group
It’s very exciting to think about adding a location! Here are some issues to think about before making this big decision.
Why? If it’s to increase collections, maybe you can simply add more days or extended hours at your current location. Verify what your current patient retention is to determine if you need to mine from existing patients. Is there any area nearby that is underserved?
Where? Check your current zip code demographics and determine where most of your patients come from and if it makes sense to market that specific area. Do your due diligence regarding the number of dentists in the areas around you to make a good decision on where you may be more successful.
Will you have current patients going to a new location? You don’t want to add a location only to find that a large number of patients switch to the new location. Some cannibalism is fine, but remember the point is to increase patients/collections, not move them from one location to another.
How will you handle patients going to both offices? Contact your dental software company and have them set up the same system in the new location and set up provider numbers for each location so everyone can see past and diagnosed treatment, as well as health history, AR, etc.
How will you know if both locations are profitable? Work with your CPA to have books that show you numbers for each location as well as together, so that means you will need to post collections, payroll, dental supplies, lab, utilities, etc. per location. Monitor provider production in each location. Are some dentists and hygienists more productive in one location, and if so, why?
Who will work it? If you have a team that wants more hours, that is ideal since they already know the systems and processes you have set up. Be sure to have team members clock in hours to each location as applicable.
Need another dentist? Interviewing is critical to find the right fit. If the associate will be working alone in one of the locations, you will want to do a lot of training, so they understand their role, responsibility with the team, and simply set your expectations, then continue to monitor. Work with your dental attorney to create a job description, employment agreement, compensation, non-compete, etc.
How do I manage multiple locations? Consider hiring a manager that can oversee training, team schedules, and general practice management.
Work with your transition consultant (broker) to assist you! Contact us today.
Read MoreIt’s All in the Numbers
By As you close out this past year and reflect on the first full year without any shutdowns as 2020 brought us, it makes sense to step back and take a look at your numbers. This is the case whether you are in your first year of practice ownership, have owned your practice for ten years, or you are getting closer and closer to retirement. You should always be managing your practice to your numbers while keeping the number one goal of taking care of your patients to the best of your ability.
So that all sounds great, but how do you manage to your numbers? The first step is grabbing your Profit and Loss statement and a Production by Provider or Production by Procedure report for 2020. If you know Microsoft Excel, you can input the numbers into an Excel spreadsheet. If you don’t know Excel, you can grab your handy-dandy calculator.
Most numbers you manage to are calculated based on a percentage of your gross collections. That’s the top number on your profit and loss statement. You should take the number after returns or other credits to gross revenue. Some Profit and Loss statements may call this number Profit and others will call it Revenue.
The first number to look at is your staff expense as a percentage of revenue. Add your staff salaries, payroll tax for staff, and staff benefits. Divide that total by revenue. Your target should be about 25% of revenue. If you’re slightly above 25%, don’t worry, increasing collections while keeping staff salaries flat will help you improve this number. If you’re over 35% and you really don’t think you can improve collections, you should analyze your staff. Maybe you have too many, or maybe your staff that is overpaid. These days, it’s easy to overpay staff since they’re hard to come by. Time and time again, when we look at practice numbers, this is one of the biggest profitability killers.
The next number to look at is facilities expense as a percentage of collections. This includes your base rent plus any of the common areas that you pay for and other facilities expense – garbage, parking lot maintenance, etc. This expense should not be more than 7% to 9% of revenue. If you are significantly higher than this number, you are not maximizing your facility, overpaying on rent, or you have too big of space for what you need. You can either increase collections or decide to downsize your space, sublease space, or do something else that will help get your numbers down in the 7% to 9% range.
Dental Supplies expense is something else to look at. Divide Dental Supplies expense by revenue. The target is 6% of revenue. If you’re a few percentage points off, don’t worry about it. If you’re at 12% to 15% or higher, you may have supplies walking out the door, overstocking your supply cabinet, or you’re buying top-end products. This should be a quick fix if you have a meeting with your person that orders supplies and give them a budget.
Lab expense is similar to dental supplies. If you’re a basic crown and bridge practice, you should be at 7% to 9% of revenues if you don’t use a milling machine in-house or you don’t place a lot of implants. The latter two will skew the numbers. Negotiate with your lab if you are higher than 7% to 9%. If you’re with a high-end lab, you’re at 12% and love their work, don’t change labs. You’re only a few points off. You can make up the difference elsewhere.
The other quick measure is hygiene as a percentage of total collections. Take your Production by Provider report or Production by Procedure report and figure out how much of collections are coming out of hygiene as a percentage of total revenue. The target is to be above 30% of revenue coming from your hygiene program. If you’re in the low 20% or less and you have a general dental practice, you should take a look at your hygiene schedule and see how many patients they’re seeing per day. Maybe their schedule isn’t full, or maybe hygiene is booked out for several months and the hygienist can’t keep up. You will need to analyze this for yourself.
Looking at your numbers is something all business owners do to help them manage their practice. These are a few simple numbers that you can quickly measure a few times per year, make a few changes and you can get your overhead down below the national average of 65%. Best wishes on the New Year and may your overhead be under control.
Read More4 Interesting Things to Implement So Your Dental Office Runs Smoothly
By Dr. Mehmood Asghar
When you walk into your dental office and see your staff members bustling around you, you might assume they are working productively. But your staff and employees are constantly trying their best to catch up with their daily tasks; they are just busy – not productive.
A successful dental practice is one where routine tasks are streamlined, and all processes run smoothly. If despite your best effort, you and your team fail to achieve your key performance indicator (KPI) goals, it is time to make some changes. Here are 4 things that you can implement in your dental practice to improve productivity and ensure that your training runs smoothly:
1. Invest in Good Practice Management Software
A practice management software is not just necessary for billing purposes or to manage patient records. Modern practice management software takes most of the burden off your team’s shoulders and automates various processes. For example, instead of writing individual appointment reminder emails to patients, the software can automatically send reminders and even reschedule appointments if needed.
Besides, with modern software, you don’t need to maintain your material inventory manually. You can simply assign a barcode to all the products, and the system will record the information regarding the quantity and expiry dates of each item. The system will automatically inform you if any material is short in supply or is about to expire.
Most importantly, good practice management software allows you to manage your finances – cut unnecessary spending and increase spending in areas that matter, like buying new equipment, refurbishing the waiting room, etc. The software will provide you with a detailed overview of your earnings and expenditures, and help you identify exactly where you’re leaking money.
2. Buy State-of-the-art Equipment
Being a successful clinician requires two major things: clinical expertise and the right armamentarium. Investing in modern diagnostic or therapeutic equipment will help you improve your treatment outcome, reduce treatment time and increase productivity. For example, it would be a good idea to invest in a desktop 3D printer: instead of waiting for 1-2 weeks for your lab to prepare a patient’s crowns, why not print them chairside in one day?
Fortunately, 3D printers are much more cost-effective today than they were a few years ago. According to research by SmarTech Analysis, in-office dental 3D printers, capable of printing surgical models, implant templates, clear aligners, and even dental prostheses, may cost less than $5000 by 2021.
You may also consider investing in 3D imaging technology. Today, dental implants have become the most favorable and desirable tooth replacement option. According to the American College of Prosthodontists, over 2.3 million implant-supported crowns are made annually in the US alone. With this considerable reliance on dental implants for tooth replacement, it only makes sense to invest in equipment that aids in implant therapy. Cone-beam CT (CBCT) technology considerably improves the clinical outcome of implant and other oral surgical procedures. Besides, this technology can also be used in the early diagnosis and management of oral disease and malignancies.
3. Automate Processes
Did you know that a significant time of your employees is spent in the sterilization control room? This is not because they are lazy; it’s because they have to frequently wash, clean, and sterilize dental instruments – either because of a small autoclave machine or due to increased patient flow. Regardless of the main reason, you can improve your team’s productivity by buying a fully automated sterilization system, which takes away the multiple, time-consuming steps involved in manually sterilizing the instruments. The initial cost of such equipment might be high, but it will prove a worthwhile investment in the long run, especially considering the time saved.
4. Staff Training and Workshops
While seemingly unessential, staff training and workshops to refresh/upgrade their clinical skills and enhance their expertise in inpatient/data management software go a long way in improving their efficiency. These workshops also ensure that all staff members remember their roles and responsibilities, thereby streamlining the work in your practice.
No matter how good a clinician one is, they cannot run a successful practice unless they are seasoned managers. According to the statistics provided by the American Dental Association, the average hours worked by dentists in 1900 were 1,810.6, compared to 1448.8 hours in 2020. This downward trend shows the impact of the latest technology and good practice management in increasing dental office efficiency, productivity, and earnings. So, follow the tips given in this article to convert your practice into an efficient, productive, and profitable business.
Author bio: Dr. Mehmood Asghar is a dentist, an educator, and a researcher in dental biomaterials. He is currently working as an Assistant Professor in Dental Biomaterials at the National University of Medical Sciences, Pakistan, in addition to pursuing a Ph.D. in Dental Biomaterials. Apart from his professional activities, Dr. Asghar loves reading, writing, and working out.
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